About two-thirds of new moms notice that they have a post-baby stomach bulge that just won’t seem to go away, but don’t know the cause of it or how to fix it. That frustrating postpartum pooch is called diastasis recti (also known as DRA). Yes, it has an actual name! Today, we’re going to discuss what exactly causes this condition and how participating in physical therapy before, during, and after pregnancy can help you prevent or resolve it. Let’s get started!
What the heck is diastasis recti?
This condition is caused when the growing uterus stretches the abdominal wall and causes the fascia (connective tissue sheet), known as the linea alba, to thin and get stretched out in response to a mother’s change in hormone levels. The linea alba joins together the two sides of the rectus abdominus muscle—what most people know as the six-pack muscles—so when it thins and widens, it creates a separation of these muscles called a diastasis.
Mom translation? It’s the culprit behind your “mom tummy” that leads people to ask when you’re due while you’re holding your one-year-old.
In addition to a protruding stomach, diastasis recti can lead to long-term issues including weakened support for your back, compromised support to your organs, decreased hip stability, and pelvic dysfunctions, such as urinary stress incontinence, overactive pelvic floor muscles, and painful sex.
What are the risk factors for diastasis recti?
If you’ve experienced or are experiencing diastasis recti, you’re certainly not alone. Studies have shown that 60 percent of childbearing women experience it to some degree.
Women may be more likely to develop diastasis recti if they’re petite, carry multiple babies at one time, have had more than one pregnancy, carry their babies later in life, have poor muscle tone, or have swayback posture.
While this condition will heal naturally in most women, for some, the problem persists. At six months postpartum, 40 percent of new moms still have abdominal separation, and more than 32 percent after 12 months.
While the most common cause of diastasis recti is pregnancy, other potential causes include frequent or rapid changes in weight, stomach obesity, genetics, poor training technique, or overloading the stomach wall during heavy lifting activities.
How can I prevent diastasis recti?
If you’re planning on getting pregnant in the future, you can work to lower your risk of diastasis recti by strengthening your core muscles. The main muscles that you should target to prevent diastasis recti include:
- External abdominal oblique
- Internal abdominal oblique
- Rectus abdominis
- Transversus abdominis
Good exercises to strengthen these muscles include a pelvic tilt with a crunch on a balance ball, modified pushups, hip circles on a balance ball, cat pose, opposite arm and leg extension, and bridge stability on a ball.
Ideally, you should work with a physical therapist who can evaluate you and design a prenatal fitness program that addresses your particular weaknesses.
How can I reduce my chances of diastasis recti during pregnancy?
Having strong core muscles before pregnancy is helpful, but maintaining that strength during pregnancy is what really counts to reduce diastasis recti. While it’s important to engage your core, doing typical crunches and leg lifts can have the unintended effect of separating your abdominal muscles. Because of this, it’s best to work with a pelvic floor physical therapist who can guide and support you through your pregnancy to ensure the best outcome.
A physical therapist can help you learn the appropriate way to use your core muscles and can show you exercises that will keep your core strong. In particular, a physical therapist can help you target the deep layer of the abdominals called the transversus abdominis muscle.
Additionally, a professional can teach you how to best perform daily activities, such as lifting your baby or getting out of bed, to minimize the risk of diastasis recti. By working with a physical therapist in these ways, postpartum diastasis recti is likely to be minimal and will usually resolve within the first few weeks following your delivery.
How can I heal diastasis recti?
If you’re experiencing a postpartum pooch, don’t worry! A pelvic floor physical therapist can help you resolve it in the following ways:
- Education. Your PT can instruct you on which movements or activities you should modify or avoid as you recover.
- Postural training. Your PT can teach you how to engage your deep core muscles through posture and breathing.
- Exercise training. There are four layers of stomach muscles and addressing all of them is important for your recovery. A PT can teach you the right type and intensity of exercises for your condition and goals and help you progress through them as your core strengthens.
- Bracing. Your PT may recommend the use of taping or braces to support your core during recovery.
- Electrical muscle stimulation. This treatment gently activates the rectus abdominis muscle and has been shown to improve function and reduce the amount of separation.
You deserve to feel healthy and confident
Physical therapy is recommended as a first-line treatment for diastasis recti and can play an important role in preventing and resolving this condition. Try not to feel embarrassed if you’re experiencing the ever-frustrating “mommy tummy”—it’s natural and common. There’s no need to suffer in silence—reach out to a pelvic floor physical therapist today and be on your way to a full recovery!
References:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5013086/
https://blog.nasm.org/womens-fitness/how-to-prevent-diastasis-recti-with-crunches
